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Mladen Djurasovic, Katlyn E McGraw, Kelly Bratcher, Charles H Crawford, John R Dimar, Rolando M Puno, Steven D Glassman, R Kirk Owens, Leah Y Carreon
OBJECTIVE The goal of this study was to determine efficacy and cost-effectiveness of Cell Saver in 2- and 3-level lumbar decompression and fusion. METHODS Patients seen at a tertiary care spine center who were undergoing a posterior 2- or 3-level lumbar decompression and fusion were randomized to have Cell Saver used during their surgery (CS group, n = 48) or not used (No Cell Saver [NCS] group, n = 47). Data regarding preoperative and postoperative hemoglobin and hematocrit, estimated blood loss, volume of Cell Saver blood reinfused, number of units and volume of allogeneic blood transfused intraoperatively and postoperatively, complications, and costs were collected...
August 17, 2018: Journal of Neurosurgery. Spine
Caroline A Dufault
Perioperative nurses care for patients undergoing a wide range of surgical procedures. One fast-growing surgical specialty is spine surgery performed using minimally invasive techniques. Patients may be candidates for minimally invasive spine surgery based on their presenting signs and symptoms and medical imaging test results. Open anterior and posterior surgical approaches to spine surgery are how surgeons traditionally have performed these procedures. However, new technology has enabled a minimally invasive lateral approach to the spine...
August 2018: AORN Journal
Paul Park, David R Nerenz, Ilyas S Aleem, Lonni R Schultz, Michael Bazydlo, Shujie Xiao, Hesham M Zakaria, Jason M Schwalb, Muwaffak M Abdulhak, Mark E Oppenlander, Victor W Chang
BACKGROUND: Most studies have evaluated 30-d readmissions after lumbar fusion surgery. Evaluation of the 90-d period, however, allows a more comprehensive assessment of factors associated with readmission. OBJECTIVE: To assess the reasons and risk factors for 90-d readmissions after lumbar fusion surgery. METHODS: The Michigan Spine Surgery Improvement Collaborative (MSSIC) registry is a prospective, multicenter, and spine-specific database of patients surgically treated for degenerative disease...
August 3, 2018: Neurosurgery
Kyle Mueller, David Zhao, Osiris Johnson, Faheem A Sandhu, Jean-Marc Voyadzis
BACKGROUND: Surgical site infection (SSI) in spinal surgery contributes to significant morbidity and healthcare resource utilization. Few studies have directly compared the rate of minimally invasive surgery (MIS) SSI with open surgery. OBJECTIVE: To investigate whether MIS techniques had a lower SSI rate in degenerative lumbar procedures as compared with traditional open techniques. METHODS: A single-center, retrospective review of a prospectively collected database was queried from January 2013 to 2016 for adult patients who underwent lumbar decompression and/or instrumented fusion for which the surgical indication involved degenerative disease...
August 9, 2018: Operative Neurosurgery (Hagerstown, Md.)
Tetsuji Inoue, Masaya Mizutamari, Kazuaki Fukuda, Kuniaki Hatake
STUDY DESIGN: This was a single-institute retrospective study. OBJECTIVE: To evaluate postoperative complications in dialysis-dependent patients undergoing elective cervical and lumbar decompression surgery. SUMMARY OF BACKGROUND DATA: Spinal surgery in dialysis-dependent patients is very challenging due to the high risk of serious postoperative complications and mortality associated with their fragile general condition. However, the outcome of decompression surgery alone has not been evaluated in such patients...
September 1, 2018: Spine
Jason Pui Yin Cheung, Karen Yiu, Kenny Kwan, Kenneth M C Cheung
BACKGROUND: There is no agreement on frequency of distractions of magnetically controlled growing rods (MCGRs) but more frequent and smaller amounts of distractions mimic physiological spine growth. The mid- to long-term follow-up and management at skeletal maturity is unknown. OBJECTIVE: To analyze patients with mean 6 yr of follow-up and describe the fate of MCGR graduates. METHODS: Early onset scoliosis (EOS) patients treated with MCGRs with minimum 4 yr of follow-up and/or at graduation were studied...
August 9, 2018: Neurosurgery
Themistocles S Protopsaltis, Bassel G Diebo, Renaud Lafage, Jensen K Henry, Justin S Smith, Justin K Scheer, Daniel M Sciubba, Peter G Passias, Han Jo Kim, D Kojo Hamilton, Alexandra Soroceanu, Eric O Klineberg, Christopher P Ames, Christopher I Shaffrey, Shay Bess, Robert A Hart, Frank J Schwab, Virginie Lafage
STUDY DESIGN: Retrospective analysis. OBJECTIVE: To define thoracic compensation and investigate its association with postoperative reciprocal thoracic kyphosis and proximal junctional kyphosis (PJK) SUMMARY OF BACKGROUND DATA.: Adult spinal deformity (ASD) patients recruit compensatory mechanisms like pelvic retroversion and knee flexion. However, thoracic hypokyphosis is a less recognized compensatory mechanism. METHODS: Patients enrolled in a multicenter ASD registry undergoing fusions to the pelvis with UIV between T9-L1 were included...
August 9, 2018: Spine
Benjamin Khechen, Brittany E Haws, Mundeep S Bawa, Dil V Patel, Kaitlyn L Cardinal, Jordan A Guntin, Simon P Lalehzarian, Kern Singh
STUDY DESIGN: Retrospective Cohort OBJECTIVE.: To determine if comorbidity as determined by Charlson Comorbidity Index (CCI) is associated with inpatient complication rate, length of stay (LOS), or direct hospital costs after minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF). SUMMARY OF BACKGROUND DATA: In the spine literature, comorbidity burden has been associated with an increased risk for complications, prolonged LOS, and greater hospital costs...
August 7, 2018: Spine
Stavros Oikonomidis, Ghazi Ashqar, Thomas Kaulhausen, Christian Herren, Jan Siewe, Rolf Sobottke
BACKGROUND: Dynamic spine implants were developed to prevent adjacent segment degeneration (ASD) and adjacent segment disease (ASDi). Purpose of this study was to investigate the clinical and radiological outcomes of "topping off" devices following lumbar spinal fusion procedure using a PEEK-based dynamic rod system. Moreover, this study focused on the hypothesis that "topping off" devices can prevent ASD. METHODS: This prospective nonrandomized study included patients with indication for single-level lumbar fusion and radiological signs of ASD without instability...
August 9, 2018: Journal of Orthopaedic Surgery and Research
Fengping Gan, Jianzhong Jiang, Zhaolin Xie, Shengbin Huang, Ying Li, Guoping Chen, Haitao Tan
BACKGROUND: To investigate the clinical efficacy of minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion in the treatment of the thoracic and lumbar spinal tuberculosis. METHODS: From January 2013 to January 2016, 35 cases with thoracic and lumbar spinal tuberculosis received direct lateral approach debridement, interbody bone grafting, and interbody fusion. Of the 35 cases, 16 patients were male and 19 were female and the median age was 55...
August 7, 2018: BMC Musculoskeletal Disorders
Ryan Adams, Sarah Herrera-Nicol, Arthur L Jenkins
Background  Advancements in radiological imaging and diagnostic criteria enable doctors to more accurately identify lumbosacral transitional vertebrae (LSTV) and their association with back and L5 distribution leg pain. It is considered the most common congenital anomaly of the lumbosacral spine with an incidence between 4 and 35%, 3 although many practitioners describe 10 to 12% overall incidence. LSTVs include sacralization of the L5 vertebral body and lumbarization of the S1 segment while demonstrating varying morphology, ranging from broadened transverse processes to complete fusion...
July 2018: Journal of Neurological Surgery Reports
Nissim Ackshota, Alysa Nash, Ian Bussey, Mark Shasti, Luke Brown, Vijay Vishwanath, Zanaib Malik, Kelley E Banagan, Eugene Y Koh, Steven C Ludwig, Daniel E Gelb
BACKGROUND CONTEXT: The incidence of pyogenic vertebral osteomyelitis (PVO) continues to increase in the United States, highlighting the need to recognize unique challenges presented by these cases and develop effective methods of surgical management. To date, no prior research has focused on the outcomes of PVO requiring two or more contiguous corpectomies. PURPOSE: To describe our experience in the operative management of PVO in 56 consecutive patients who underwent multilevel corpectomies (≥2 vertebral bodies) via a combined approach...
August 3, 2018: Spine Journal: Official Journal of the North American Spine Society
Ronen Blecher, Emre Yilmaz, Marc Moisi, Rod J Oskouian, Jens Chapman
The authors describe a 67-year-old man with a prior history of alcohol abuse who presented with a complaint of worsening low back pain. Four months prior to his presentation, the patient had undergone extreme lateral interbody fusion (XLIF) of his lumbar 3-4 segment for the treatment of his chronic low back and legs pain. Imaging revealed a loosening of his interbody fusion implant on top of his prior lumbar spine instrumentation. In surgery, the removal of his loose implant was followed by decompression, the stabilization of the collapsed segment, and the implant of antibiotic-impregnated polymethyl-methacrylate (PMMA) spacer and beads...
May 31, 2018: Curēus
Chao Xia, Leilei Xu, Bingchuan Xue, Fei Sheng, Yong Qiu, Zezhang Zhu
BACKGROUND: Proximal junctional kyphosis (PJK) is a common phenomenon following long segmental fusion surgery of adolescent idiopathic scoliosis (AIS). However, the inability to reliably identify vertebral endplates on lateral upright radiographs has made an accurate measurement of proximal junctional angle (PJA) technically impossible in many patients. The aim of this study was to determine whether a grayscale inversion view is more reliable to measure PJA and to assess PJK accurately...
August 2, 2018: World Neurosurgery
Lei Kong, Xi-Fu Shang, Wen-Zhi Zhang, Li-Qun Duan, Yang Yu, Wei-Jian Ni, Yan Huang
BACKGROUND: Sufficient decompression of the nerve root canal is still regarded as the method of choice when operating on patients with lumbar disc herniation (LDH) with lumbar lateral recess stenosis; however, tissue-sparing procedures are becoming more popular. Endoscopic techniques offer advantages and the benefits of rehabilitation, which have become the standard in many surgical operations when operating on the spine. A significant issue has been the upgrading of instruments to provide enough bone resection under continuous visual control...
August 3, 2018: Der Orthopäde
Piyush Kalakoti, Yubo Gao, Nathan R Hendrickson, Andrew J Pugely
STUDY DESIGN: Retrospective, observational study OBJECTIVE.: To examine the influence of patient, hospital, and procedural characteristics on hospital costs and length of stay (LOS). SUMMARY OF BACKGROUND DATA: Successful bundled payment agreements require management of financial risk. Participating institutions must understand potential cost input before entering into these episodes-of-care payment contracts. Elective anterior cervical discectomy and fusion (ACDF) has become a popular target for early bundles given its frequency and predictability...
August 2, 2018: Spine
Azeem Tariq Malik, Nikhil Jain, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: Retrospective review of prospective registry OBJECTIVE.: To analyze the impact of metabolic syndrome (MetS) on 30-day outcomes following elective anterior cervical discectomy and fusions (ACDFs). SUMMARY OF BACKGROUND DATA: MetS is defined as the presence of a combination of hypertension, diabetes mellitus and obesity. Past literature has reported MetS to complicate post-operative care in patients undergoing various surgical procedures, including lumbar fusions...
August 2, 2018: Spine
James L West, Madison Arnel, Atilio E Palma, John Frino, Alexander K Powers, Daniel E Couture
OBJECTIVE Spine surgery is less common in children than adults. These surgeries, like all others, are subject to complications such as bleeding, infection, and CSF leak. The rate of incidental durotomy in the pediatric population, and its associated complications, has scarcely been reported in the literature. METHODS This is a retrospective chart review of all pediatric patients operated on at Wake Forest Baptist Health from 2012 to 2017 who underwent spine surgeries. The authors excluded any procedures with intended durotomy, such as tethered cord release or spinal cord tumor resection...
August 3, 2018: Journal of Neurosurgery. Pediatrics
Tatsuya Yasuda, Tomohiko Hasegawa, Yu Yamato, Daisuke Togawa, Sho Kobayashi, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yukihiro Matsuyama
OBJECTIVE The purpose of this study was to evaluate the effect of position on lumbar lordosis (LL) in adult spinal deformity (ASD) patients. METHODS The authors evaluated the radiographic data of ASD patients who underwent posterior corrective fusion surgery from the thoracic spine to L5, S1, or the ilium for the treatment of ASD of the lumbar spine. The spinopelvic parameters were measured in the standing position preoperatively. LL was also evaluated in the supine position preoperatively and in the prone position on the surgical frame...
August 3, 2018: Journal of Neurosurgery. Spine
Azeem T Malik, Nikhil Jain, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: The main objective of this article was to investigate the impact of discharge destination on postdischarge outcomes following an elective 1- to 2-level posterior lumbar fusion (PLF) for degenerative pathology. BACKGROUND DATA: Discharge to an inpatient care facility may be associated with adverse outcomes as compared with home discharge. MATERIALS AND METHODS: The 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was used to query for patients undergoing PLFs using Current Procedural Terminology (CPT) codes (22612, 22630, and 22633)...
July 31, 2018: Clinical Spine Surgery
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